Week 8 - Endocrine Disorders

Question 1

What is DM 1?

Answer 1

Autoimmune destruction of beta cells in the pancreas

Antibodies to beta cells are present in 75% of cases

Question 2

in type 2 DM, insulin levels are high because

Answer 2

Loss of insulin sensitivity

Question 3

90% of diabetics are type (1 or 2)?

Answer 3

Type 2

Question 4

Types of Secondary diabetes

Answer 4

Result of pancreatic disease, hormone disturbances, drugs, malnutrition

Question 5

What is glucose intolerance during pregnancy?

Answer 5

Gestational diabetes

Question 6

Risk factors for Type I DM (5)

Answer 6

Poor protein digestion (environmental and dietary)
Enteroviruses and rotavirus which are common in children
Vitamin D deficiency
Omega 3 FA deficiency
Nitrates

Question 7

Risk factors for type 2 DM

Answer 7

Obesity

Family history

Question 8

Low adiponectin [increases/decreases] risk of DMII?

Answer 8

Increases

Question 9

PCOS [increases/decreases] risk of DMII?

Answer 9

Increases

Question 10

Increased waist/hip ratio [increases/decreases] risk of DMII?

Answer 10

Increases

Question 11

Sx of DM

Answer 11

Polyuria (urination)
Polydipsia (thirst)
Polyphagia (hunger)

Fatigue
Blurred visitor
Poor wound healing
Periodontal disease (gum disease)
Frequent infections

Question 12

What is peripheral neuropathy?

Answer 12

Pain, burning, tingling, numbness of feet and lower legs

Question 13

Autonomic neuropathy?

Answer 13

Causes Sx related to dysfunction of an organ system (e.g. urinary incontinence, diarrhea / constipation, sexual dysfunction)

Question 14

What is the MC complication of diabetes?

Answer 14

Diabetic neuropathy

• Damage to the nerves as a result of diabetes
• Can affect different parts fo the body, mild to severe Sx

Question 15

How to Dx DM? (4 tests)

Answer 15

Fasting blood glucose
Postpandrial glucose
Glucose tolerance test
Glycosylated hemoglobin (HbA1C)

Question 16

What is the Fasting blood glucose test?

Answer 16

Blood draw after 10-16hr fast

Question 17

What are normal Fasting blood glucose levels?
Impaired?
DM?

Answer 17

70-99 mm/dL
Impaired: >110 dL and <126 mg/dL
DM: >126 mg/dL

Question 18

What is the postpandrial glucose test?

Answer 18

Taken 2 hours after a meal

Question 19

DM levels from a postpandrial glucose test?

Answer 19

> 200 mg/dL

Question 20

What is the glucose tolerance test?

Answer 20

Patient drinks glucose solution

Blood samples taken every 30-120 minutes

Question 21

Normal glucose tolerance test (GTT) levels?
Pre-diabetes?
Dm?

Answer 21

1 hour: <150 mg/dL
2 hour: <120 mg/dL

Pre-diabetes:
2 hour: 140-180 mg/dL

DM:
1 hour: >180
2 hour: >150

Question 22

Normal HbA1c levels?

DM levels?

Answer 22

5-7%

DM: Up to 20%

Question 23

Graves’ disease is an autoimmune condition that is an example of

Answer 23

Hyperthyroidism

Too much T3/T4 circulating in the blood

Question 24

In Graves’ disease, TSH is [low/high]

Answer 24

Low TSH (produced by pituitary)

Auto-antibody is binding the the TSH receptor which keeps a constant, unregulated T3/T4 production.

Question 25

Symptoms of Graves’ disease

Answer 25

Exophthalmos Diffuse goiter Tachycardia; warm, thin, moist skin Weakness, sweating, weight loss, nervousness, loose stools, heat intolerance, irritability, fatigue

Question 26

Tests to Dx Graves’ disease

Answer 26

Physical exam Ultrasound for thyroid gland Laboratory diagnosis: T3/T4 levels

Question 27

Hashimoto’s thyroiditis is hyper/hypothyroidism?

Answer 27

Hypothyroidism Antibodies are generated against thyroid peroxidase (TPO)

Question 28

Sx of Hashimoto’s

Answer 28

``` Fatigue, sluggishness Increased cold sensitivity Constipation Pale, dry skin Weight gain Goiter Menorrhagia (excessive menstrual bleeding) ```

Question 29

Tests to Dx Hashimoto’s disease

Answer 29

Hormone test: T4/T3 are low and TSH is high (opposite of graves) Antibody test to confirm presence of antibodies against TPO

Question 30

What is happening in hypoadrenalism?

Answer 30

Adrenal cortex does not produce enough glucocorticoids (e.g. cortisol), mineralcorticoids (e.g. aldosterone), and sex steroids (e.g. testosterone)

Question 31

Addison’s disease is [excessive / deficient] amount of cortisol

Answer 31

Deficient

Question 32

Cushing’s disease is [excessive / deficient] amount of cortisol

Answer 32

Excessive

Question 33

What does aldosterone do?

Answer 33

Regulates blood pressure by increasing sodium reabsorption and water in the kidney and increasing elimination of potassium

Question 34

DHEA is used to

Answer 34

Make sex hormones: androgen (from testes) and estrogen (from ovaries)

Question 35

Sx of hypoadrenalism:

Answer 35

``` Chronic fatigue Muscle weakness Loss of appetite, nausea, vomiting, diarrhea Weight loss Abdominal pain Low BP Irritability and depression Hypoglycemia HA Sweating Irregularly /absent menstrual periods Hyperpigmentation - Addison’s disease ```

Question 36

How to Dx hypoadrenalism

Answer 36

``` ACTH stimulation test CRH stimulation test Ultrasound to visualize adrenal glands Tuberculin skin test (to see if adrenal insufficiency is related to TB) Antibody blood tests Hormonal blood tests ```